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Center to Improve Veteran Involvement in Care (CIVIC)

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CIVIC Core Investigators

Steven K Dobscha, MD

Steven Dobscha, MD is CIVIC’s Director. His research focuses on topics that are highly relevant to the care of Veterans including chronic pain, prescription opiate use, suicide prevention, and patient-centered care. Dr. Dobscha has received prior HSR&D funding for studies of depression and chronic pain collaborative care, studies that examined care received in proximity to suicidal ideation and suicide, and studies of impacts of Veteran electronic access to mental health progress notes. He also recently partnered with the Technology and Telehealth (T2) group at Joint Base Lewis-McChord to examine effectiveness of a smartphone app in reducing suicidal thoughts; this study was funded by the Military Research Consortium. Dr. Dobscha and his team are currently developing and evaluating a program to train primary care clinicians to deliver means safety messaging to Veterans at risk for suicide seen in primary care settings. Dr. Dobscha serves as Research Consultant for the VA Portland Health Care System Mental Health and Clinical Neuroscience Division and as Primary Care Mental Health Integration Champion for VA Portland Health Care System. Dr. Dobscha has served on several HSR&D CDA Scientific Merit Review Boards. He is Professor of Psychiatry at Oregon Health & Science University, and national VA Representative to the Military Suicide Research Consortium Advisory Board and a member of several other scientific advisory boards.



A Patient-Centered Intervention to Improve Opioid Safety (Co-Investigator)

This randomized controlled trial will compare outcomes from two different interventions designed to reduce prescription opioid abuse and improve safety for patients prescribed opioid medications.
Principal Investigator: Benjamin Morasco
Grant ID: 1I01HX001583

Advancing Suicide Prevention for Female Veterans (Co-Investigator)

The over-arching goal of this work is to inform gender-tailored suicide prevention approaches, using a large, national sample of female and male Veterans with recent non-fatal suicidal self-directed violence (SSV: fatal and non-fatal suicide attempts). We aim to develop and test explanatory models of female and male risk for a repeat SSV event over 12 months, and identify similarities and differences in patterns of healthcare utilization, coping strategies, and symptom change over time between female and male Veterans at risk for SSV.
Principal Investigator: Lauren Denneson
Grant ID: IIR 17-131

Using Behavioral Economics to Enhance Appointment Reminders and Reduce Missed Visits (Co-Investigator)

The overarching objective of this proposal is to test the effectiveness of simple and scalable enhancements to appointment reminders in reducing no-shows, and prepare for larger-scale implementation.
Principal Investigator: Alan Teo
Grant ID: IIR 17-134

Chronic Pain Management and Patient-Centered Outcomes Following Discontinuation of Long-Term Opioid Therapy (Co-Investigator)

The goal of this VA HSR&D career development award is to characterize pain treatment utilization in veterans with co-occurring substance use disorders and develop and test the preliminary effectiveness of a collaborative pain intervention for veterans with chronic pain receiving specialty treatment for alcohol and drug use disorders.
Principal Investigator: Travis Lovejoy
Grant ID: IIR 17-268


  • Chen JI, Mastarone GL, Ambrosino SA, Anzalone N, Carlson KF, Dobscha SK, Teo AR. Evaluation of the Safety and Design of Community Internet Resources for Veteran Suicide Prevention. Crisis. 2019 Apr 2 [Epub ahead of print]: 1-8. doi: 10.1027/0227-5910/a000590
  • Morasco BJ, Dobscha SK, Hyde S, Mitchell SH. Exploratory study examining associations between prescription opioid dose and delay discounting in patients with chronic pain. Journal of Opioid Management. 2019;15(1):19-25. doi: 10.5055/jom.2019.0482.
  • Wyse JJ, Ganzini L, Dobscha SK, Krebs EE, Morasco BJ. Setting Expectations, Following Orders, Safety, and Standardization: Clinicians’ Strategies to Guide Difficult Conversations About Opioid Prescribing. Journal of General Internal Medicine. 2019 Apr 22. doi: 10.1007/s11606-019-04983-y.
  • Denneson LM, Pisciotta M, Hooker ER, Trevino A, Dobscha SK. Impacts of a web-based educational program for veterans who read their mental health notes online. Journal of the American Medical Informatics Association. 2019;26(1);3-8.
  • Morasco BJ, Krebs EE, Adams MH, Hyde S, Zamudio J, & Dobscha SK. Clinician response to aberrant urine drug test results of patients prescribed opioid therapy for chronic pain. Clinical Journal of Pain. 2019;35(1):1-6.
  • Pisciotta MK, Denneson LM, Williams HB, Woods S, Tuepker A, Dobscha SK. Impacts of a web-based educational program for veterans who read their mental health notes online, Journal of Mental Health. 2019;26(1):3-8.


Linda Ganzini, MD, MPH

Linda Ganzini, MD, MPH is CIVIC Associate Director and Professor of Psychiatry and Medicine at Oregon Health and Science University. Her research focuses on ethics, end of life care, suicide and barriers to medical care among patients with comorbid medical and psychiatric disorders. Within CIVIC her primary focus is on mentoring and assisting young investigators, as well as developing the Center's community participatory research emphasis. Dr. Ganzini is Co-Director of the VA Health Services Research Fellowship. Dr. Ganzini organizes the COIN Center Research Conferences and meets regularly with junior investigators for a "research in progress" session.


Dr. Ganzini has no active projects at this time.


  • Nugent SM, Slatore CG, Ganzini L, Golden SE, Zive D, Vranas KC, Sullivan DR. POLST registration and associated outcomes among Veterans with advanced-stage lung cancer. American Journal of Hospice and Palliative Medicine. 2019 Jan 30;36(7):564-570. doi: 10.1177/1049909118824543. PMID 30700127
  • Wyse JJ, Ganzini L, Dobscha SK, Krebs EE, Morasco BJ. Setting Expectations, Following Orders, Safety, and Standardization: Clinicians’ Strategies to Guide Difficult Conversations About Opioid Prescribing. Journal of General Internal Medicine. 2019 Apr 22. doi: 10.1007/s11606-019-04983-y.

 

Kathleen Carlson, MS, PHD

Kathleen Carlson, MS, PhD is a CIVIC Core Investigator and Associate Professor of Epidemiology at the Oregon Health and Science University (OHSU) School of Public Health. Dr. Carlson trained in injury epidemiology and health services research and has been conducting VA research since 2006. She participated in the VA Advanced Fellowship in Health Services Research at the Minneapolis VA Healthcare System from 2006-2008 and completed a VA HSR&D Career Development Award from 2010-2015. Dr. Carlson's work focuses on the co-occurrence of physical and psychological trauma among returning Veterans and their post-deployment reintegration into families, work, and community; she is currently examining employment outcomes and vocational services for Veterans diagnosed with traumatic brain injury (TBI). Her research also focuses on the epidemiology, prevention, and control of TBI and other traumatic injuries; opioid and other medication safety; firearm-related injuries; and epidemiology of, and clinical services for, tinnitus. Dr. Carlson teaches Masters- and Doctoral-level epidemiology students in the School of Public Health. She serves as Co-Director of the CIVIC HSR&D advanced fellowship with Dr. Ganzini, leading the training and development of social scientist fellows.

Advancing Suicide Prevention for Female Veterans (Co-Investigator)

The over-arching goal of this work is to inform gender-tailored suicide prevention approaches, using a large, national sample of female and male Veterans with recent non-fatal suicidal self-directed violence (SSV: fatal and non-fatal suicide attempts). We aim to develop and test explanatory models of female and male risk for a repeat SSV event over 12 months, and identify similarities and differences in patterns of healthcare utilization, coping strategies, and symptom change over time between female and male Veterans at risk for SSV.
Principal Investigator: Lauren Denneson
Grant ID: IIR 17-131

Effects of Military Noise Exposure on Auditory Function in Service Members and Recently Discharged Veterans (Co-Investigator)

This proposal serves as a continuation to study # PR121146. The objective of this longitudinal epidemiologic study is to estimate and describe the prevalence, etiology, and effects of early-onset tinnitus and hearing loss among newly-discharged military Veterans.
Principal Investigator: James Henry
Grant ID: JW160036

Longitudinal Effects of Mild TBI and Other Military Exposures on Auditory Functioning in Recently-Discharged Veterans and Active Duty Service Members – CENC Study 1 (Site Principal Investigator)

The proposed project would expand an ongoing longitudinal epidemiology study to focus specifically on the auditory sequelae of mild traumatic brain injury among recent combat Veterans. This study will help estimate the direct effects of mild TBI on auditory dysfunction while accounting for potentially confounding factors such as noise and ototoxic exposures, post-traumatic stress disorder, and number of and time-since mild TBI events.
Grant ID: I01 CX001135

Interagency Database Linkage: Precursors of Firearm Injuries and Suicide (Principal Investigator)

This grant serves as a demonstration project for a probabilistic linkage of multiple databases managed by VA and various entities within the State of Oregon. Data will be used to examine the epidemiology of firearm-related injuries among post-deployment Veterans.
Grant ID: MH112201

Chronic Tinnitus among Veterans with and without TBI: Service Needs and Interests (Principal Investigator)

The goal of this 2-year mixed-methods study is to examine the prevalence of bothersome tinnitus among Veterans with and without TBI and assess their interests in an evidence-based tinnitus management program.
Grant ID: C2216-P

Use of a Prescription Drug Monitoring Program to Evaluate Concurrent VA and non-VA Opioid Prescriptions (Principal Investigator)

This mixed methods project will examine the frequency and patterns of dual use of opioid and benzodiazepine prescribers among the entire population of OEF/OIF/OND Veterans in Oregon (Aim 1); identify rates of, and risk factors for, all (VA- and non-VA-treated; fatal and nonfatal) opioid/benzodiazepine-related adverse events (Aim 2); and describe barriers and facilitators of state PDMP use among VA opioid prescribers (Aim 3).
Grant ID: IIR 15-091

Evaluation of a Work-Family and Sleep Leadership Intervention in the Oregon National Guard: A Behavioral Health Leadership Approach (Co-Investigator)

This RCT will develop and test an intervention involving behavioral health leadership combined with an individual service member health promotion program. Effects of the intervention on outcomes will be examined within the context of the Oregon National Guard.
Principal Investigator: Leslie Hammer
Grant ID: DoD CDMRP IIR

Improving Access to Supported Employment for Veterans with Polytrauma/Traumatic Brain Injury (Co-Investigator)

The purpose of this study is to increase access to Supported Employment (SE) among OEF/OIF/OND Veterans with polytrauma/traumatic brain injury by identifying actionable barriers and facilitators to SE referral, developing and implementing a customizable intervention package, and conducting preliminary assessment of its effectiveness at local VA sites that are below SE capacity.
Principal Investigator: Terri K Pogoda
Grant ID: I01 HX002162-01A1

Effects of Opioid and Other Psychotropic Drug Exposures on Long-term Outcomes of TBI: Developing Measurement Best Practices (Principal Investigator)

The goal of this 2-year study will be to generate the methods and preliminary data needed for subsequent research focused on opioids and neurological health among Veterans with TBI.
Grant ID: N3197-P


  • Carlson KF, Gilbert TA, O’Neil ME, Zaugg TL, Manning CA, Kaelin C, Thielman EJ, Reavis KM, Henry JA. Healthcare Utilization and Mental Health Diagnoses among Veterans with Tinnitus. American Journal of Audiology. 2019 Apr;28(1S): 181-190. doi: 10.1044/2018_AJA-TTR17-18-0042.
  • Carlson KF, Sell SB, Vachhani J, Folmer R, Saunders G, Feeney MP. Enhancing Screening Systems to Facilitate Hearing Healthcare Access: A Qualitative Study. Journal of the American Academy of Audiology. 2019 Apr;30(4):250-263. doi: 10.3766/jaaa.15087.
  • Chen JI, Mastarone GL, Ambrosino SA, Anzalone N, Carlson KF, Dobscha SK, Teo AR. Evaluation of the Safety and Design of Community Internet Resources for Veteran Suicide Prevention. Crisis. 2019 Apr 2 [Epub ahead of print]: 1-8. doi: 10.1027/0227-5910/a000590.
  • Hanson KT, Carlson KF, Friedeman-Sanchez G, Meis LA, Van Houtven CH, Jensen AC, Phelan SM, Griffin JM. Family Caregiver Satisfaction with Inpatient Rehabilitation Care. PLOS One. 2019 Mar 15;14(3): e0213767. doi: 10.1371/journal.pone.0213767.
  • Henry JA, Griest SE, Blankenship C, Thielman EJ, Theodoroff SM, Hammill T, Carlson KF. Impact of Tinnitus on Military Service Members. Military Medicine. 2019 Mar 21;184(3/4): 604-614. doi: 10.1093/milmed/usy328.
  • McCabe CT, Mohr CD, Hammer LB, Carlson KF. PTSD Symptomology and Motivated Alcohol Use among Military Service Members: Testing a Conditional Indirect Effect Model of Social Support. Substance Use and Misuse. 2018 Oct 29;54(2):257-270. doi: 10.1080/10826084.2018.1517176.

 

Jason I Chen, PHD

Jason I. Chen, PhD is a CIVIC Research Fellow, Assistant Professor of Psychiatry and Clinical Psychology Program Research Faculty at OHSU. He received his PhD in Clinical Psychology from the University of South Florida in 2016 where he focused on mechanisms of suicide risk and the implementation and dissemination of suicide prevention programming. Dr. Chen completed his APA accredited internship at the VA Eastern Colorado Health Care System and a postdoctoral fellowship in health services research at CIVIC. His research interests include suicide prevention for high risk populations, community-based approaches, and help-seeking processes. Dr. Chen is currently a K12 scholar in the Oregon Emergency Care Research Training Multidisciplinary Research Training Program (5K12HL133115). As a K12 scholar, Dr. Chen will be characterizing ED care for suicidal patients and identifying gaps in current best practices to inform the development of future ED-based interventions. He anticipates beginning his VA HSR&D-funded Career Development Award in July 2019 which will develop a community engagement intervention for recently psychiatrically hospitalized Veterans. Dr. Chen also serves on the OHSU Zero Suicide Initiative Committee where he provides technical support and training for OHSU staff and community partners.

Enhancing Social Connectedness Among Veterans at High Risk for Suicide through Community Engagement (Principal Investigator)

The current project proposes to develop and pilot a multicomponent, peer-support facilitated intervention for increasing social connectedness through participation in community activities among Veterans at elevated risk of death by suicide via the following research aims: 1) Identify Veterans’ current behaviors, needs, and preferences for community engagement following psychiatric hospitalization, 2) Identify VHA staff and community stakeholder perceptions and perceived needs related to Veteran community engagement following psychiatric hospitalization, and 3) Develop and pilot a multicomponent, peer-support facilitated intervention for increasing social connectedness among Veterans at elevated risk of death by suicide. Expected outcomes from these aims include clinical toolkits for VA and community stakeholders, academic manuscripts and presentations, and two HSR&D IIR submissions over the course of the CDA award period.
Grant ID:1IK2HX002787-01/CDA 18-185

Characterizing Emergency Department Care for Suicidal Patients (Principal Investigator)

The goal of this project is to characterize Emergency Department (ED) care received by suicidal patients and examine relationships between the care received in EDs of several health care systems (VA Portland Health Care System, or VAPORHCS, and Oregon Health & Science University, or OHSU) and subsequent utilization outcomes.
Grant ID:


  • Chen JI, Mastarone GL, Ambrosino SA, Anzalone N, Carlson KF, Dobscha SK, Teo AR. Evaluation of the Safety and Design of Community Internet Resources for Veteran Suicide Prevention. Crisis. 2019 Apr 2 [Epub ahead of print]: 1-8. doi: 10.1027/0227-5910/a000590.
  • Peterson AL, Chen JI, Karver M., Labouliere CD. Frustration with feeling: Latent classes of non-suicidal self-injury and emotional regulation difficulties. Psychiatry Research. 2019 May;275:61-70. doi: 10.1016/j.psychres.2019.03.014

 

Lauren M Denneson, MS, PHD

Lauren M. Denneson, MS, PhD, trained in social psychology and public health, has worked in health services research in VHA since 2009. Dr. Denneson's primary areas of interest are solution-focused approaches to mental health care and promotion of psychological well-being, especially among patients at risk for suicide. Her current projects include a large, national study examining gender differences in suicide risk, resilience, and recovery. She also serves as the lead evaluator for the VA Portland Health Care System’s Whole Health transformation, a national VHA initiative that aims to transform VHA into a patient-centered health care system that facilitates patient self-management and empowerment. Her work also focuses on developing the evidence base for health coaching and she recently completed work examining the use of health coaching among Veterans at varying levels of risk for suicide. Dr. Denneson completed her BA in Psychology at the University of Minnesota and her MS and PhD in Applied Social Psychology at Portland State University.

Advancing Suicide Prevention for Female Veterans (Co-Investigator)

The over-arching goal of this work is to inform gender-tailored suicide prevention approaches, using a large, national sample of female and male Veterans with recent non-fatal suicidal self-directed violence (SSV: fatal and non-fatal suicide attempts). We aim to develop and test explanatory models of female and male risk for a repeat SSV event over 12 months, and identify similarities and differences in patterns of healthcare utilization, coping strategies, and symptom change over time between female and male Veterans at risk for SSV.
Principal Investigator: Lauren Denneson
Grant ID: IIR 17-131

Implementation of a Pragmatic Trial of Whole Health Team vs. Primary Care Group Education to Promote Non-Pharmacological Strategies to Improve Pain, Functioning, and Quality of Life in Veterans (Co-Investigator)

The goal of this UG3/UH3 proposal is to conduct a pragmatic implementation-effectiveness trial in which we will develop, pilot and implement two care delivery approaches for over 600 veterans with moderate to severe chronic pain who will be randomized to receive either: (1) an intensive Whole Health Team (WHT) approach versus (2) a less intensive, usual care Primary Care Group Education (PC-GE).
Principal Investigator: Karen Seal and William Becker
Grant ID: 1UG3AT009765


  • Denneson LM, Pisciotta M, Hooker ER, Trevino A, Dobscha SK. Impacts of a web-based educational program for veterans who read their mental health notes online. Journal of the American Medical Informatics Association. 2019;26(1);3-8.
  • Pisciotta MK, Denneson LM, Williams HB, Woods S, Tuepker A, Dobscha SK. Impacts of a web-based educational program for veterans who read their mental health notes online, Journal of Mental Health. 2019;26(1):3-8.

 

Samuel Edwards, MD, MPH

Samuel Edwards, MD, MPH is a primary care physician, general internist, and health services researcher at the Portland Veterans Affairs (VA) Health Care System and an Assistant Professor of Medicine at Oregon Health & Science University (OHSU). Dr. Edwards’s research focuses on the role and function of primary care in health systems, with a focus on the care for high needs individuals through Home-Based Primary Care (HBPC). His Career Development Award uses mixed methods to explore what features of HBPC drive its success in reducing hospitalizations for ambulatory care sensitive conditions, and uses these insights to develop an intervention to promote best practices in HBPC.
Dr. Edwards received his medical degree from the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, received his training in internal medicine at Beth Israel Deaconess Medical Center, and completed fellowship in General Medicine and Primary Care at Harvard Medical School, VA Boston Healthcare System and Brigham and Women’s Hospital.

Optimizing Outcomes in Home-Based Primary Care (HBPC) (Principal Investigator)

This project uses mixed methods to explore what features of HBPC drive its success in reducing hospitalizations for ambulatory care sensitive conditions, and will use these insights to develop an intervention to promote best practices in HBPC.
Grant ID: CDA 16-152

Innovators Network – Population factors, Organizational capacity, Workflow and Resources (IN-POWR)

This comprehensive Partnered Evaluation Initiative will identify impacts of VA Innovators Network training and other activities on employee engagement and retention as well as return on investment and impacts on health care utilization/quality of care metrics associated with innovations developed by Network members.
Principal Investigators: Anais Tuepker, Sarah Cutrona, Anita Vashi, and George Jackson

Evaluating system change to advance learning and take evidence to scale (ESCALATES) (Co-Investigator)

In ESCALATES we are evaluating the efforts of 7 regional collaboratives efforts to improve the use of evidence based guidelines in 1500 smaller primary care practices, to determine the most effective strategies to disseminate and implement evidence based practice in primary care.
Principal Investigator: Deborah Cohen
Grant ID: 1R01HS023940-01

Action Oriented Evaluation of Interprofessional Learning Efforts in the COEPCE and IAPACT Environments

This project established a Partnered Evaluation Center with the goal of evaluating the development, dissemination and adoption of tools to promote interprofessional training and learning throughout VA primary care, looking at impacts on the organization of care delivery, patient outcomes, and employee/trainee experience.
Principal Investigator: Anais Tuepker
Grant ID: PEC 15-247


  • Chan B, Edwards ST, Devoe M, Gil R, Mitchell M, Englander H, Nicolaidis C, Kansagara D, Saha S, Korthuis PT. The SUMMIT ambulatory-ICU primary care model for medically and socially complex patients in an urban federally qualified health center: study design and rationale. Addiction Science & Clinical Practice. 2018 Dec 14;13(1):27. PMID: 30547847.
  • Edwards ST, Kim H, Shull S, Hooker ER, Niederhausen M, Tuepker A. Quality of Outpatient Care With Internal Medicine Residents vs Attending Physicians in Veterans Affairs Primary Care Clinics. JAMA Internal Medicine. 2019 Apr;179(5):711-713. doi:10.1001/jamainternmed.2018.8624

 

Graeme Forrest, MBBS, FIDSA

Graeme Forrest, MBBS, FIDSA is an infectious disease specialist and Associate Professor of Medicine at the VA Portland Healthcare System and Oregon Health and Science University (OHSU). He has been involved with several VA collaborative studies and CREATE projects, including the prevention of surgical site infections study, hand hygiene study and prevention of MRSA project. Currently he is working on a prevention of diabetic foot infection study with the VA collaborative studies section. Dr Forrest is the director of the antimicrobial stewardship program, outpatient antibiotic therapy program and provides training for the fellowship program in outcomes research with antibiotic utilization. Dr Forrest is also the Co-Chair of the Institutional Review Board at the VA medical center.

Checklist to Prevent MRSA Surgical Site Infections (Site Principal Investigator)

The CREATE project was HSR and D funded for evaluating procedures and practices to reduce MRSA transmission through the VA and within surgery. This study has been extended as data has shown marked reductions in infections and data is needed for dissemination.
Principal Investigator: Eli N. Perencevich
Grant ID: CRE 12-291

Improving Empiric Therapy in Ambulatory Care (Consultant)

This project is evaluating the antibiotic resistance profile of patients cultures to determine and algorithm for selection of empiric antibiotic therapy.
Principal Investigator: Jessina McGregor
Grant ID: 1R01HS022706-01A1

A Phase 3, Placebo-Controlled, Randomized, Observer-Blinded Study to Evaluate the Efficacy, Safety, and Tolerability of a Clostridium Difficile Vaccine in Adults 50 Years of Age and Older

Phase 3 commercial study evaluating in blinded fashion vaccine versus placebo to determine vaccine efficacy against C. difficile.
Principal Study Director: Pfizer

Investigation of Rifampin to Reduce Pedal Amputations for Osteomyelitis in Diabetics (Local Principal Investigator)

Prospective study to evaluate the addition of rifampin to standard therapy for treatment of diabetic foot infections.
Principal Investigator: Mary T Bennesen
Grant ID: CSP-2001


  • Furuno JJ, Tallman G, Noble B, Bubalo J, Forrest GN, Lewis J, Beinvenida A, Holmes C, Weber B, McGregor J. Clinical Outcomes of the Oral Suspension versus Delayed-release Tablet Formulations of Posaconazole for Prophylaxis of Invasive Fungal Infections. Antimicrob Agents and Chemother. 2018 Sep 24;62. PMID: 30012757
  • Jindai K, Goto M, MacKay K, Forrest GN, Musuuza J, Safdar N, Pfeiffer CD. Improving fluoroquinolone use in the outpatient setting using a patient safety initiative. Infect Control Hosp Epidemiol. 2018 Sep;39(9):1108-1111. PMID 30115219


Mark Helfand, MD, MS, MPH

Mark Helfand, MD, MS, MPH is Professor of Medicine and Professor of Medical Informatics and Clinical Epidemiology at the Oregon Health & Science University. He is board-certified in Internal Medicine and practices hospital medicine at the Portland VA Medical Center, where he is a staff physician. He directs the VA Evidence-Based Synthesis Program Coordinating Center, and the West Coast branch of the US Cochrane Center.

Dr. Helfand is the PI of a newly funded HSR&D project, DIPEx USA: Veteran Experiences with Social Reintegration after TBI. He has served on the Methodology Committee of the Patient-Centered Outcomes Research Institute since 2011, and was Editor-in-chief of Medical Decision Making from 2005 to 2012. Dr. Helfand received an AB and BS from Stanford University, an MD and MPH from University of Illinois Medical School, and an MS in health services research from Stanford University.

Listening to Gulf War Vets: A qualitative Inquiry into the Health Experience and Treatment of those with Chronic Multisymptom Illness (Principal Investigator)

The first comprehensive qualitative study of the health experiences of Gulf War era veterans will yield significant insight into the features of effective care models and treatments, as well as satisfaction with care. It will also create a rich, ongoing resource that can inform VA’s efforts to improve customer service and care for these veterans, identify better illness-specific health measures and promising therapeutic approaches, and activate veterans to be more engaged with the health system.
Grant ID: SDR 17-151

Peer Review of PCORI’s Funded Research (Principal Investigator)

Develop, evaluate, refine and maintain a structure and process for scientific peer review that aligns with the procedures for peer review of primary research and public release of research findings approved by the PCORI Board of Governors. We will also promote the scientific robustness and integrity of research evidence used by patients, clinicians, purchasers and policymakers for making informed health decisions. Peer review metrics will be collected and examined to assess process performance; identify areas where additional training, support or modifications are needed; and advance the science of peer review.


  • Kim KK, Helfand M. Engagement in PCORnet Research Networks. Med Care. 2018 Oct;56 Suppl 10 Suppl 1:S1-S3. doi: 10.1097/MLR.0000000000000958. PMID: 30074945

 

Denise Hynes, MPH, PHD, RN

Denise Hynes, MPH, PhD, RN has been a Research Scientist in the US Department of Veterans Affairs since 1991 and joined CIVIC as a Core Investigator in 2018. She is an experienced nurse, health services researcher, and data scientist. Her research focuses on innovative approaches to improve healthcare quality and access. Her service focuses on database and informatics methods to support research and evaluation of healthcare interventions.

She received her Bachelor of Science in Nursing degree from Loyola University of Chicago, Master of Public Health degree from Johns Hopkins University, School of Hygiene and Public Health, and her Doctoral degree (PhD) from the University of North Carolina at Chapel Hill, School of Public Health. She completed postdoctoral training at the Cecil B. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill and at Drexel University through the Hedwig van Ameringen Executive Leadership for Academic Medicine (ELAM) in 2014. She served as tenure track faculty at Duke University, Loyola University Chicago, and the University of Illinois at Chicago. Dr. Hynes also holds an appointment at Oregon State University as Professor in the College of Public Health and Human Sciences and as the Director of the new Health Data & Informatics (HDI) Center in the Center for Genome Research and Biocomputing.

Access, Costs, & Effectiveness Evaluation of Care in the Community Using a Multi-Method Approach (Principal Investigator)

To assist and partner with the VA Office of Community Care to advise, implement, and evaluate the expanded VA Community care program. We are exploring information needs of healthcare providers who treat Veterans with specific medical conditions, access to care, and care coordination strategies, and economic impacts.
Grant ID: SDR 17-155

Care Coordination and Outcomes in the VA Expanded Choice Program (Principal Investigator)

To partner with the VA Office of Community Care to plan and evaluate the expanded VA Community care program. We are evaluating care coordination processes and quality of care under the expanded Choice; role of health information exchange and quality governance.
Grant ID: In response to HX-18-008

Long Term Effects of Military Service on Health and Aging-Veterans Aging: Longitudinal study in ORegon (VALOR) (Advisor)

Developing methods and preliminary data for a cohort study of resilience and aging in US Veterans in Oregon.
Grant ID: XNV 98-012


  • Cordasco KM, Hynes DM, Mattocks KM, Bastian LA, Bosworth HB, Atkins DA. Improving Care Coordination for Veterans within VA and Across Healthcare Systems. Journal of General Internal Medicine. 2019 May 16 [Epub ahead of print] PMID: 31098970. doi: 10.1007/s11606-019-04999-4.
  • McDonald KM, Singer SJ, Sheinfeld-Gorin S, Haggstrom DA, Hynes DM, Charns MP, Yano EM, Lucatorto MA, Zulman DM, Ong MK, Axon RN, Vogel D, Upton M. Incorporating Theory into Practice: Reconceptualizing Exemplary Care Coordination Initiatives from the US Veterans Health Delivery System. Journal of General Internal Medicine. 2019 May 16 [Epub ahead of print]. doi: 10.1007/s11606-019-04969-w. PMID: 31098965.
  • Peterson K, Anderson J, Bourne D, Charns MP, Sheinfeld Gorin S, Hynes DM, McDonald KM, Singer SJ, Yano EM. Health Care Coordination Theoretical Frameworks: A Systematic Scoping Review to Increase Their Understanding and Use in Practice. Journal of General Internal Medicine. 2019 May 16 [Epub ahead of print]. doi: 10.1007/s11606-019-04966-z. PMID: 31098976.


Devan Kansagara, MD, MCR

Devan Kansagara, MD, MCR is Associate Professor of Medicine and Associate Professor of Medical Informatics and Clinical Epidemiology at Oregon Health and Science University. He practices internal medicine in the VA Portland Health Care System. One of his areas of interest is evidence based medicine, and the use of evidence to guide health policy. Dr Kansagara directs the Portland Evidence-based Synthesis Program, one of four sites nationally responsible for developing evidence syntheses to help guide VA policy. He is currently the Vice Chair of the American College of Physicians Clinical Guidelines Committee, and also works on health policy for the Oregon Health Authority. Dr Kansagara's other main area of interest is health systems redesign. In particular, he has done intervention and implementation work with hospital to home care transitions and the patient centered medical home. Dr Kansagara completed his BA in English at Amherst College. He received an MD from the University of Connecticut School of Medicine, and completed residency training at Yale University. He received his Masters in Clinical Research from Oregon Health and Science University.

Action Oriented Evaluation of Interprofessional Learning Efforts in the COEPCE and IAPACT Environments (Co-Investigator)

This project established a Partnered Evaluation Center with the goal of evaluating the development, dissemination and adoption of tools to promote interprofessional training and learning throughout VA primary care, looking at impacts on the organization of care delivery, patient outcomes, and employee/trainee experience.
Principal Investigator: Anais Tuepker
Grant ID: PEC 15-247


  • Chan B, Edwards ST, Devoe M, Gil R, Mitchell M, Englander H, Nicolaidis C, Kansagara D, Saha S, Korthuis PT. The SUMMIT ambulatory-ICU primary care model for medically and socially complex patients in an urban federally qualified health center: study design and rationale. Addiction Science & Clinical Practice. 2018 Dec 14;13(1):27. PMID: 30547847.

 

Travis Lovejoy, PHD, MPH

Travis Lovejoy, PhD, MPH is a clinical psychologist with specialized training in quantitative methodologies, health psychology, behavioral medicine, and substance use disorders. Dr. Lovejoy’s research interests include the scientific development, testing, and implementation of theory-based clinical and health services interventions that improve individual and population health. He is currently in the 4th year of a 5-year VA HSR&D-funded Career Development Award that examines novel treatment approaches for chronic pain in veterans with co-occurring substance use disorders. Additional VA-funded research examines patient outcomes following discontinuation of long-term opioid therapy. Dr. Lovejoy’s research approaches include large retrospective administrative database studies, prospective cohort studies, clinical and health services efficacy and effectiveness trials, and mixed methods approaches to study the implementation of evidence-based practices. Dr. Lovejoy is the Lead of the CIVIC Implementation Science Core and Executive Committee Member of the Oregon Health & Science University Dissemination & Implementation Research Collaborative.

Chronic Pain Management and Patient-Centered Outcomes Following Discontinuation of Long-Term Opioid Therapy (Principal Investigator)

The goal of this VA HSR&D career development award is to characterize pain treatment utilization in veterans with co-occurring substance use disorders and develop and test the preliminary effectiveness of a collaborative pain intervention for veterans with chronic pain receiving specialty treatment for alcohol and drug use disorders.
Grant ID: IIR 17-268

Reducing HIV risk behavior in depressed and non-depressed older adults with HIV (Principal Investigator)

This randomized controlled trial tests the efficacy of telephone-administered motivational interventional and behavioral skills training to reduce HIV sexual transmission risk behavior in HIV-positive older adults with and without depression.
Grant ID: R01AG053081

Enhancing sexual safety: couples' communication and HIV testing with YMSM (Co-Investigator)

To evaluate dyadic communication and HIV prevention among adolescent men-who-have-sex-with-men (MSM) couples.
Principal Investigator: Tyrel Starks and Sarah Feldstein Ewing
Grant ID: U19HD089875-03S1


  • Kumthekar A, Shull S, Lovejoy TI, Morasco BJ, Chang M, Barton JL. Impact of hepatitis C treatment on pain intensity, prescription opioid use, and arthritis. International Journal of Rheumatic Diseases. 2019 Feb 6;22:592-598. doi: 10.1111/1756-185X.13479.

 

Benjamin Morasco, PHD

Benjamin Morasco, PhD is a staff psychologist at the VA Portland Health Care System and Associate Professor in the Department of Psychiatry at Oregon Health and Science University. His primary research focus is on improving the safety and effectiveness of treatment for chronic pain. Dr. Morasco’s currently funded projects are examining chronic pain treatment outcomes for patients prescribed chronic opioid therapy, evaluating barriers and facilitators for different strategies to reduce prescription opioid abuse, and conducting a randomized trial of an intervention designed to improve the safety of opioid therapy for patients with chronic pain. He also collaborates on other projects examining strategies for improving pain care for veterans living in rural settings, opioid discontinuation, treating pain in patients with substance use disorders, and decision support to improve safety in pain management. He is a member of the Portland VA Research and Development committee, serves on local and national pain management workgroups, and is a supervisor with the clinical psychology training program at the VA Portland Health Care System. 

 

Chronic Pain Management and Patient-Centered Outcomes Following Discontinuation of Long-Term Opioid Therapy (Co-Investigator)

The goal of this VA HSR&D career development award is to characterize pain treatment utilization in veterans with co-occurring substance use disorders and develop and test the preliminary effectiveness of a collaborative pain intervention for veterans with chronic pain receiving specialty treatment for alcohol and drug use disorders.
Principal Investigator: Travis Lovejoy
Grant ID: IIR 17-268

A Patient-Centered Intervention to Improve Opioid Safety (Principal Investigator)

This randomized controlled trial will compare outcomes from two different interventions designed to reduce prescription opioid abuse and improve safety for patients prescribed opioid medications.
Grant ID: 1I01HX001583

Use of a Prescription Drug Monitoring Program to Evaluate Concurrent VA and non-VA Opioid Prescriptions (Co-Investigator)

This mixed methods project will examine the frequency and patterns of dual use of opioid and benzodiazepine prescribers among the entire population of OEF/OIF/OND Veterans in Oregon (Aim 1); identify rates of, and risk factors for, all (VA- and non-VA-treated; fatal and nonfatal) opioid/benzodiazepine-related adverse events (Aim 2); and describe barriers and facilitators of state PDMP use among VA opioid prescribers (Aim 3).
Principal Investigator: Kathleen Carlson
Grant ID: IIR 15-091

Chronic Pain Management in Veterans with Co-Occurring Substance Use Disorders (Co-Mentor)

This is a career development award for Dr. Travis Lovejoy to develop research and clinical expertise in chronic pain treatment for patients with comorbid substance use disorders.
Principal Investigator: Travis Lovejoy
Grant ID: CDA-13-268

Risk for Opioid Abuse and Misuse in Adolescence (Co-Investigator)

This project will examine trajectories of pain and opioid use over time in adolescents who receive opioid prescriptions in outpatient medical settings.
Principal Investigator: Wilson and Feldstein-Ewing
Grant ID: R01DA044778

Implementation of a Pragmatic Trial of Whole Health Team vs. Primary Care Group Education to Promote Non-Pharmacological Strategies to Improve Pain, Functioning, and Quality of Life in Veterans (Site Principal Investigator/Co-Investigator)

The goal is to conduct a pragmatic implementation-effectiveness trial in which we will develop, pilot and implement two care delivery approaches for over 600 veterans with moderate to severe chronic pain who will be randomized to receive either: (1) an intensive Whole Health Team (WHT) approach versus (2) a less intensive, usual care Primary Care Group Education (PC-GE).
Principal Investigator: Karen Seal and Becker
Grant ID: 1UG3AT009765

Comparative effectiveness of patient-centered strategies to improve pain management and opioid safety for veterans (Site Principal Investigator/Co-Investigator)

This pragmatic clinical trial will compare two strategies to improve pain and reduce opioid use.
Principal Investigator: Krebs
Grant ID: OPD-1511-33052

Correlates and Outcomes of Opioid Dose Escalation among Chronic Pain Patients (Principal Investigator

This is a multi-site prospective cohort study examining patients who are receiving a stable dose of chronic opioid therapy for the treatment of chronic pain. We will examine factors that predict which patients will receive an increase in opioid dose and evaluate clinical outcomes associated with opioid dose escalation.
Grant ID: 1R01DA034083


  • Kumthekar A, Shull S, Lovejoy TI, Morasco BJ, Chang M, Barton JL. Impact of hepatitis C treatment on pain intensity, prescription opioid use, and arthritis. International Journal of Rheumatic Diseases. 2019 Feb 6;22:592-598. doi: 10.1111/1756-185X.13479.
  • Morasco BJ, Dobscha SK, Hyde S, Mitchell SH. Exploratory study examining associations between prescription opioid dose and delay discounting in patients with chronic pain. Journal of Opioid Management. 2019;15(1):19-25. doi: 10.5055/jom.2019.0482.
  • Wyse JJ, Ganzini L, Dobscha SK, Krebs EE, Morasco BJ. Setting Expectations, Following Orders, Safety, and Standardization: Clinicians’ Strategies to Guide Difficult Conversations About Opioid Prescribing. Journal of General Internal Medicine. 2019 Apr 22. doi: 10.1007/s11606-019-04983-y.
  • Morasco BJ, Krebs EE, Adams MH, Hyde S, Zamudio J, & Dobscha SK. Clinician response to aberrant urine drug test results of patients prescribed opioid therapy for chronic pain. Clinical Journal of Pain. 2019;35(1):1-6.

 

Maya O'Neil, PHD

Maya O'Neil, PhD is a CIVIC Core Investigator and neuropsychologist at the VA Portland Health Care System (OR Psychologist License #2248). She is also an Associate Professor at Oregon Health and Science University in the Departments of Psychiatry and Medical Informatics and Clinical Epidemiology. She recently completed an AHRQ-supported K Fellowship focused on patient experiences related to PTSD and cognitive functioning. Her current research focuses on assessing and treating cognitive problems in Veterans with PTSD, which was recently funded by the VA through a Career Development Award. She is a neuropsychologist on the Rural Telemental Health clinical team at the Portland VA. She supervises practicum students, interns, and postdoctoral fellows, and assesses and treats patients with PTSD and other commonly comorbid conditions like depression and traumatic brain injury. She is the Principal Investigator of two OHSU projects funded by AHRQ and the National Center for PTSD examining randomized controlled trial data on PTSD interventions. She has also been the Principal Investigator of multiple Systematic Reviews of mental health and traumatic brain injury topics for the VA. Her current research examines how PTSD treatment and cognitive problems interact, and how to best treat the cognitive problems associated with PTSD. In her spare time she bikes, swims, and walks her 4 dogs. 

 

Assessment and Treatment of Cognitive Functioning Deficits in Veterans with PTSD (Principal Investigator)

This grant is a mentored career development award. The studies supported by this grant will assess cognitive functioning among Veterans who receive PTSD treatment, and will pilot test Compensatory Cognitive Training, a cognitive rehabilitation program, for Veterans with PTSD and cognitive problems.
Grant ID: 1 IK2 RX002762-01A1

Cognitive Rehabilitation for Older Veterans with Mild Cognitive Impairment (MCI) (Co-Investigator)

This multi-site randomized control trial will evaluate the efficacy of a manualized cognitive rehabilitation intervention for older adults with MCI. The intervention was developed by Drs. Huckans and Twamley (MPIs) and is called “Compensatory Cognitive Training (CCT).”
Principal Investigator: Elizabeth W. Twamley
Grant ID: 1I01CX001592-01

Listening to Gulf War Vets: A qualitative Inquiry into the Health Experience and Treatment of those with Chronic Multisymptom Illness (Co-Investigator)

The first comprehensive qualitative study of the health experiences of Gulf War era veterans will yield significant insight into the features of effective care models and treatments, as well as satisfaction with care. It will also create a rich, ongoing resource that can inform VA’s efforts to improve customer service and care for these veterans, identify better illness-specific health measures and promising therapeutic approaches, and activate veterans to be more engaged with the health system.
Principal Investigator: Mark Helfand
Grant ID: SDR 17-151

Longitudinal Effects of Mild TBI and Other Military Exposures on Auditory Functioning in Recently-Discharged Veterans and Active Duty Service Members – CENC Study 1 (Co-Investigator)

The proposed project would expand an ongoing longitudinal epidemiology study to focus specifically on the auditory sequelae of mild traumatic brain injury among recent combat Veterans. This study will help estimate the direct effects of mild TBI on auditory dysfunction while accounting for potentially confounding factors such as noise and ototoxic exposures, post-traumatic stress disorder, and number of and time-since mild TBI events.
Principal Investigator: Kathleen Carlson
Grant ID: I01 CX001135

Interagency Database Linkage: Precursors of Firearm Injuries and Suicide (Co-Investigator)

This grant serves as a demonstration project for a probabilistic linkage of multiple databases managed by VA and various entities within the State of Oregon. Data will be used to examine the epidemiology of firearm-related injuries among post-deployment Veterans.
Principal Investigator: Kathleen Carlson
Grant ID: MH112201

Cognitively Augmented Behavioral Activation for Veterans with Comorbid TBI/PTSD (Co-Investigator)

This study assesses the efficacy of a cognitively augmented behavioral activation individual treatment intervention with returning Veterans from the recent conflicts in Iraq and Afghanistan.
Principal Investigators: Daniel M Storzbach and Wagner
Grant ID: 1I01RX001189-01A2


  • Carlson KF, Gilbert TA, O’Neil ME, Zaugg TL, Manning CA, Kaelin C, Thielman EJ, Reavis KM, Henry JA. Healthcare Utilization and Mental Health Diagnoses among Veterans with Tinnitus. American Journal of Audiology. 2019 Apr;28(1S): 181-190. doi: 10.1044/2018_AJA-TTR17-18-0042.

 

Sarah Ono, PhD

Sarah Ono, PhD is a cultural anthropologist with extensive ethnographic and qualitative data experience who specializes in the complementarity of interview, observational, and focus group methods in health services research settings. Dr. Ono joined CIVIC as a Core Investigator and qualitative methodologist in 2014. Previously, she directed the Qualitative Core for CADRE, the Veterans Rural Health Resource Center-Central Region, and the VISN 23 PACT Demonstration Lab at the Iowa City VA Health Care System. Past projects include: rural access to health care; HIV telehealth care delivery; VA use of new media; smoking cessation interventions; policy implementation; dual-use and co-management; PACT implementation; and military sexual trauma. Her current focus is on patient-centered care, Veteran engagement in research, novel methods and health care delivery innovations, and implementation of participatory approaches to health care. Dr. Ono is an Assistant Professor in Family Medicine at Oregon Health & Science University.

Communicating the Impact of mTBI on Post-Deployment Reintegration using Photovoice (Co-Investigator/Site Principal Investigator)

This project will use community-engaged photovoice methods to: 1) identify and describe community reintegration experiences and needs of Veterans and their families; and 2) empower Veterans and family caregivers affected by TBI to communicate their unmet needs, goals of care, and treatment preferences to key VA and community stakeholders (e.g., clinicians, program managers, administrative leadership, policymakers, and community service organizations). The study will build VHA’s organizational capacity for engaging OEF/OIF/OND Veterans and family caregivers in health services research and dissemination of findings.
Principal Investigator: Jennifer True
Grant ID: IIR 14-399

Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care (Co-Investigator)

This project will evaluate patient-centered outcomes and communication practices for Veterans and clinicians engaged in lung cancer screening.
Principal Investigator: Christopher Slatore
Grant ID: 128737-RSG-15-155-01-CPPB

Evaluating system change to advance learning and take evidence to scale (ESCALATES) (Co-Investigator, Qualitative Co-Lead)

In ESCALATES we are evaluating the efforts of 7 regional collaboratives efforts to improve the use of evidence based guidelines in 1500 smaller primary care practices, to determine the most effective strategies to disseminate and implement evidence based practice in primary care.
Principal Investigator: Deborah Cohen
Grant ID: 1R01HS023940-01


  • Denneson LM, Trevino AY, Kenyon EA, Ono S, Pfeiffer PN, Dobscha SK. Health coaching to enhance psychological well-being among veterans with suicidal ideation: A pilot study. Journal of General Internal Medicine. 2018.
  • Edwards ST, Marino M, Balasubramanian BA, Solberg L, Valenzuela S, Springer R, Stange KC, Miller WL, Kottke TE, Perry CK, Ono S, Cohen DA. Burnout Among Physicians, Advanced Practice Clinicians and Staff in Smaller Primary Care Practices. J Gen Intern Med. 2018;33(12):2138-2146.

 

Christopher D Pfeiffer, MD, MHS

Christopher D. Pfeiffer, MD, MHS serves as the Hospital Epidemiologist and Section Chief of Infectious Diseases at the VA Portland Health Care System (VAPORHCS) and Associate Professor of Medicine at the Oregon Health and Science University (OHSU). Dr. Pfeiffer’s areas of interest include healthcare-associated infection, multidrug-resistant organisms (MDROs), hospital epidemiology, and infections in the immunocompromised host. His work is centered around preventing, detecting, and controlling the spread of of multidrug-resistant organisms (MDROs) with a particular focus on carbapenem-resistant Enterobacteriaceae (CRE). He serves as Medical Director for the Drug-Resistant Organism Prevention and Coordinated Regional Epidemiology (DROP-CRE) Network with the Oregon Health Authority (OHA) and is involved in multicenter research collaborations. Most notable is his role as Principal Investigator of a CDC-funded project to implement a novel electronic system to track patients with MDROs such as CRE as they are transferred from VA facility-to-facility across the country. Dr. Pfeiffer is also a co-investigator for the VA HSR&D-funded CREATE projects, a VA CSP study of treatment for recurrent Clostridium Difficile, and a NIH-funded study of clinician decision making.

Incorporating Bayesian reasoning into physician testing and treatment decisions (Site Principal Investigator/Co-Investigator)

Major goal: Examine how poor probabilistic reasoning makes physicians underestimate the likelihood of false positive tests and overestimate treatment effects, which leads to over-diagnosis and overtreatment. Interventions will be developed with visual aids.
Principal Investigator: Daniel J Morgan
Grant ID: NIH 1DP2LM012890-01

Optimal Treatment for Recurrent Clostridium Difficile (OpTION) (Site Principal Investigator/Co-Investigator)

Major goal: To determine whether fidaxomicin and vancomycin followed by taper and pulse vancomycin treatment are superior to standard vancomycin treatment for the treatment of recurrent Clostridium difficile infection.
Principal Investigator: Stuart B Johnson and Dale N Gerding
Grant ID: CSP 596

Preventing Spread of carbapenem-resistant Enterobacteriaceae (CRE) among Veterans through an Automated Tracking System (Principal Investigator)

Major goal: Implement a novel electronic system to track patients with multidrug-resistant organisms such as CRE as they are transferred from facility-to-facility across the country.
Grant ID: IAA 18FED1808462CKD


  • Fitzpatrick MA, Suda KJ, Ramanathan S, Guihan M, Brown C, Safdar N, Evans M, Jones MM, Pfeiffer CD, Klutts JS, Icardi M, Perencevich E, Rubin M, Evans CT; QUERI CARRIAGE Program. Laboratory practices for identification and reporting of carbapenem-resistant Enterobacteriaceae in Department of Veterans Affairs facilities. Infection Control & Hospital Epidemiology. 2019 Apr;40(4):463-466. doi: 10.1017/ice.2019.24. PMID: 30829187.

 

Somnath Saha, MD, MPH

Somnath Saha, MD, MPH is a CIVIC core investigator and Professor of Medicine and Public Health at the Oregon Health & Science University (OHSU). He has maintained a research program focused on health care disparities and patient-provider relationships since completing his HSR&D CDA in 2009. He is currently leading a multi-center VA study, "Opening the Black Box of Cultural Competence" (IIR 14-007). He is a co-investigator on three other CIVIC projects: "A Patient-Centered Intervention to Improve Opioid Safety" (IIR 14-020), led by Dr. Morasco; “Use of a Prescription Drug Monitoring Program to Evaluate Concurrent VA and non-VA Opioid Prescriptions” (IIR 15-091), led by Dr. Carlson; and “Chronic Pain Management and Patient-centered Outcomes Following Discontinuation of Long-Term Opioid Therapy” (approved for VA HSR&D funding), led by Dr. Lovejoy. Dr. Saha serves as Secretary for the Society of General Internal Medicine (SGIM) and serves on the Research Committees of both SGIM and the Academy of Communication in Healthcare. He is also a member of SGIM’s Health Equity Commission. He recently resumed his role serving as a reviewer on the HSR&D Scientific Merit Review Board. 

Opening the Black Box of Cultural Competence (Principal Investigator)

The goal of this project is to understand differences in the way providers with high vs. low levels of “cultural competence” interact with patients, through direct observation of patient-provider communication and interviews with patients.
Grant ID: IIR 14-007-3

Maximizing Respect and Improving Outcomes in HIV and Substance Abuse (MaRIPOHSA) (Consultant)

The major goal of this study is to create a repository of audio-recorded patient-provider encounters that will be used to measure communication and its impact on patients with HIV and substance use disorders.
Principal Investigator: Mary Catherine Beach
Grant ID: 1R01DA037601-01

A Patient-Centered Intervention to Improve Opioid Safety

This is a randomized controlled trial to evaluate the efficacy of a primary care-based intervention designed to reduce prescription opioid abuse and medication-related adverse effects.
Principal Investigator: Benjamin Morasco
Grant ID: IIR 14-020

Use of a Prescription Drug Monitoring Program to Evaluate Concurrent VA and non-VA Opioid Prescriptions

This mixed methods project will examine the frequency and patterns of dual use of opioid and benzodiazepine prescribers among the entire population of OEF/OIF/OND Veterans in Oregon (Aim 1); identify rates of, and risk factors for, all (VA- and non-VA-treated; fatal and nonfatal) opioid/benzodiazepine-related adverse events (Aim 2); and describe barriers and facilitators of state PDMP use among VA opioid prescribers (Aim 3).
Principal Investigator: Kathleen Carlson
Grant ID: IIR 15-091

Assessing the Potential for a State Medicaid Reform Model to Reduce Disparities (Co-Investigator)

This study evaluates the role of Medicaid in reducing disparities for racial and ethnic minorities, by examining the effectiveness of reforms targeting disparities reduction and of community health workers and related approaches that can be adopted across Medicaid programs.
Principal Investigator: Kenneth J McConnell
Grant ID: 1R01MD011212


  • Burgess DJ, Bokhour BG, Cunningham BA, Do T, Eliacin J, Gordon HS, Gravely A, Jones DM, Partin MR, Pope C, Saha S, Taylor BC, Gollust SE. Communicating with providers about racial healthcare disparities: the role of providers' prior beliefs on their receptivity to different narrative frames. Patient Education and Counseling. 2019 Jan;102(1):139-147. PMID: 30266266
  • Chan B, Edwards ST, Devoe M, Gil R, Mitchell M, Englander H, Nicolaidis C, Kansagara D, Saha S, Korthuis PT. The SUMMIT ambulatory-ICU primary care model for medically and socially complex patients in an urban federally qualified health center: study design and rationale. Addiction Science & Clinical Practice. 2018 Dec 14;13(1):27. PMID: 30547847.

 

Christopher Slatore, MD, MS

Christopher Slatore, MD, MS is a CIVIC Core Investigator and Associate Professor at Oregon Health & Science University. Dr. Slatore completed his HSR&D CDA in 2015, which was a mixed-methods study of the relationship between communication strategies and patient-centered outcomes among patients with pulmonary nodules. He published nine journal articles directly related to this project. Other ongoing projects focus on the prevention, detection, treatment, and healthcare delivery for patients with tobacco-related lung diseases, chiefly lung cancer and chronic obstructive pulmonary disease (COPD). His research aims to improve patient outcomes and to develop innovative approaches to treatment in these areas. Dr. Slatore is or has been funded by the Radiation Oncology Institute, VA, American Cancer Society, and the Knight Cancer Institute to evaluate patient-centered outcomes for patients with and at risk for lung cancer. Clinically, he is helps lead several local and national programs regarding lung cancer screening and pulmonary nodule surveillance. Dr. Slatore's work has been substantially supported by our Center, including grant submission support and assistance from our statistician and data analyst.

Pulmonary Nodule Prediction: A Radiomics & Machine-Learning Approach with a Pragmatic Focus (Principal Investigator)

We will use a convolutional neural network, within a foundation of decisional science, to develop a risk model that will optimize the clinical utility and management for patients with pulmonary nodules.
Grant ID: Full4521018

Lung Cancer Screening Implementation: Key Informant Interview Study of Oregon’s Small and Rural Hospitals (Principal Investigator)

The goal of this study is to understand barriers and facilitators to implementation of high-quality lung cancer screening programs in rural and small hospitals in Oregon.
Grant ID: 2018-CCSG-12

Barriers and Facilitators to a Consolidative Cancer Screening Program (Principal Investigator)

The goal of this study is to use an implementation framework to better understand the perceived barriers and facilitators of widespread implementation of a consolidative cancer screening program.
Grant ID: VAPORHCS CIVIC LIP

Palliative Care Interventions for Outpatients Newly Diagnosed with Lung Cancer: Phase II (Site Principal Investigator)

The purpose of this randomized control trial to test the efficacy of delivering a nurse-led telephone-based intervention with the early provision of palliative care to improve patient-centered outcomes for Veterans with newly diagnosed lung cancer.
Principal Investigator: Lynn F. Reinke
Grant ID: NRI 15-456

Impact of COPD on lung-resident MAIT cell frequency, function, and recognition of bacterial infection (Consultant)

Establish how dysfunctional MAIT cell activation contributes to COPD pathology and define mechanisms driving impaired MAIT cell responses.
Principal Investigator: Harriff
Grant ID: 1 IO1 CX001562

Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care (Principal Investigator)

The goal of this study is to evaluate patient-centered outcomes among Veterans considering and undergoing lung cancer screening.
Grant ID: 128737-RSG-15-155-01-CPPB

Lung Cancer Screening Implementation: Building Blocks for Effective Implementation & Partnership (Principal Investigator)

The goal of this study is to develop a validate model of lung cancer risk among patients with pulmonary nodules and a model to identify these patients in adminstrative databases.
Grant ID: HSRD IIR 16-003

The Impact of Specialist Palliative Care Utilization on Mortality and Other Outcomes Among Lung Cancer Patients within the Veterans Affairs Health Network (Mentor)

The goal of this project is to determine the association between palliative care utilization and patient outcomes and the quality of cancer care using the national Veterans Affirs (VA) healthcare system.
Principal Investigator: Donald Sullivan
Grant ID: NIH/NCI K07CA190706

Pragmatic Trial of More versus Less Intensive Strategies for Active Surveillance of Patients with Small Pulmonary Nodules (Co-Principal Investigator)

The goal of this study is to compare two protocols for CT surveillance, both of which are supported by existing guidelines from professional societies and are consistent with current standards of care.
Principal Investigator: Christopher Slatore and Michael K Gould
Grant ID: PCS-1403-12653

Use of a Prescription Drug Monitoring Program to Evaluate Concurrent VA and non-VA Opioid Prescriptions (Co-Investigator)

This mixed methods project will examine the frequency and patterns of dual use of opioid and benzodiazepine prescribers among the entire population of OEF/OIF/OND Veterans in Oregon (Aim 1); identify rates of, and risk factors for, all (VA- and non-VA-treated; fatal and nonfatal) opioid/benzodiazepine-related adverse events (Aim 2); and describe barriers and facilitators of state PDMP use among VA opioid prescribers (Aim 3).
Principal Investigator: Kathleen Carlson
Grant ID: IIR 15-091

Comparative effectiveness of limited resection vs. SBRT (Co-Investigator)

The goal of this study is to evaluate the association of common treatments for early stage lung cancer with short and medium-term health-related quality of life.
Principal Investigator: Juan P. Wisnivesky
Grant ID: 1R01CA203193-01

Phase III Multi-Institutional Randomized Clinical Trial of Surgery versus Stereotactic Radiotherapy for Early Stage Lung Cancer

The goal of this randomized trial is to determine the risks and benefits of surgery vs. stereotactic body radiotherapy (SBRT) for patients with early stage lung cancer.
Principal Investigator: Moghanaki
Grant ID: CSP #2005


  • Nugent SM, Slatore CG, Ganzini L, Golden SE, Zive D, Vranas KC, Sullivan DR. POLST registration and associated outcomes among Veterans with advanced-stage lung cancer. American Journal of Hospice and Palliative Medicine. 2019 Jan 30;36(7):564-570. doi: 10.1177/1049909118824543. PMID 30700127
  • Sullivan DR, Eden KB, Dieckmann NF, Golden SE, Vranas KC, Nugent SM, Slatore CG. Understanding patients’ values and preferences regarding early stage lung cancer treatment decision making. Lung Cancer. 2019 May;131:47-57. doi: 10.1016/j.lungcan.2019.03.009.

 

Alan Teo, MD, MS
Alan Teo, MD, MS

Alan Teo, MD, MS, a psychiatrist, joined our Center in 2013. Dr. Teo's primary research focus is on the role of social relationships in influencing mental health outcomes. He studies how social support and social ties--with peers, family, and others--can buffer against mental illness, and conversely how social isolation may be both a risk factor and negative outcome of mental illness. He is an expert in a form of severe social withdrawal called hikikomori. He has methodological expertise in survey development and secondary data analyses of population-based datasets.

Dr. Teo's career development award (CDA) project is aimed at engaging Veterans' close social relationships in the treatment of their depression; this project is funded through 2020. Other funded research projects focus on reducing patients’ missed appointments through use of behavioral nudges, and use of social media to promote engagement in mental health care.

Clinically, Dr Teo’s interests include collaborative care and cultural psychiatry. He also enjoys opportunities to provide mentorship to physicians interested in research. Dr. Teo completed training at Stanford University, University of California San Francisco, and the Robert Wood Johnson Foundation Clinical Scholars Program at University of Michigan.

Pilot Study on Autistic Adult Burnout and Suicide Behavior (Co-Principal Investigator)

The primary objective of this pilot study is to use a community-based participatory research approach to develop a way to measure autistic burnout, and gain a deeper understanding of any connections between autistic burnout and suicidal behavior.
Principal Investigator: Raymaker and Alan Teo
Grant ID: OHSU-PSU Collaborative Research Program

Using Behavioral Economics to Enhance Appointment Reminders and Reduce Missed Visits (Principal Investigator)

The primary objective of this study is to design and evaluate the effect of appointment reminders enhanced by principles of behavioral economics versus standard appointment reminders on no-show rates and other access-related metrics in primary care and mental health clinics.
Grant ID: VA HSR&D IIR

Optimizing Veterans Social Relationships to Enhance Depression Care (Principal Investigator)

The primary objective of this Career Development Award is to inform development of an intervention for primary care patients with major depression that harnesses the positive influences of close relationships on Veterans’ depression care.
Grant ID: CDA 14-428

Using Social Media to Engage At-Risk Veterans in Mental Health Treatment (Principal Investigator)

The primary objective of this study is to determine the feasibility of using Facebook for identifying military veterans at risk for psychiatric problems, then determine the appropriateness of multiple social media platforms for engaging, supporting, and assisting these at-risk veterans.
Grant ID: Medical Research Foundation of Oregon New Investigator Grant 1603

Using Social Media for Suicide Prevention: Planning a Community-partnered, Scalable Public Health Strategy (Principal Investigator)

The primary objective of this Innovation Grant submission is to prepare for development and evaluation of a novel suicide prevention intervention called SMART (Social Media Assistance with Referral and Training).
Grant ID: HX-18-020


  • Chen JI, Mastarone GL, Ambrosino SA, Anzalone N, Carlson KF, Dobscha SK, Teo AR. Evaluation of the Safety and Design of Community Internet Resources for Veteran Suicide Prevention. Crisis. 2019 Apr 2 [Epub ahead of print]: 1-8. doi: 10.1027/0227-5910/a000590.
  • Kato TA, Katsuki R, Kubo H, Shimokawa N, Sato-Kasai M, Hayakawa K, Kuwano N, Tateno M, Setoyama D, Kang D, Watabe M, Sakamoto S, Teo AR, Kanba S. Development and validation of the 22-item Tarumi’s Modern-Type Depression Trait Scale: Avoidance of Social Roles, Complaint, and Low Self-Esteem (TACS-22). Psychiatry and Clinical Neurosciences. 2019 Mar. doi: 10.1111/pcn.12842. PMID: 30900331.
  • Tateno M, Kim D, Teo AR, Skokauskas N, Guerrero AP, Kato TA. Smartphone addiction in Japanese college students: usefulness of the Japanese version of the Smartphone Addiction Scale as a screening tool for a new form of internet addiction. Psychiatry Investigation. 2019 Feb;16(2):115-120. doi: 10.30773/pi.2018.12.25.2. PMID: 30808117.
  • Teo AR, Markwardt S, Hinton L. Using Skype to Beat the Blues: Longitudinal Data from a National Representative Sample. American Journal of Geriatric Psychiatry. 2019 Mar;27(3):254-262. pii: S1064-7481(18)30535-9. doi: 10.1016/j.jagp.2018.10.014. PMID: 30442532.

 

Christopher Tessier, MD

Christopher Tessier, MD practices general adult urology at the Portland VA Medical Center. He has served on several committees and panels in the American Urological Association’s (AUA) Science & Quality Division, and is the current chair of the AUA's Choosing Wisely and EHR workgroups. His current research interests include Shared Decision Making applications for urologic diseases, as well as reducing antibiotic overuse. Dr. Tessier attended medical school at Jefferson Medical College in Philadelphia and completed his urology residency at the Hospital of the University of Pennsylvania. He completed postgraduate training in Medical Informatics and is Dual board-certified in Urology and Clinical Informatics.

Reduction of unnecessary imaging test orders in low-risk VA patients with prostate cancer, using guideline-based clinical decision support


Principal Investigator: Makarov


  • Saitz T, Conlin M, Tessier CD, Hatch TR. The Safety and Efficacy of Transurethral Microwave Therapy in High-Risk Catheter Dependent Men at A Single Veterans Affairs Center. Turk J Urol. [epub ahead of print, 19/11/2018].

 

Anais Tuepker, PhD, MPH

Anaїs Tuepker, PhD, MPH, is a sociologist and health services researcher whose work focuses on improving interprofessional education, innovation and employee engagement, and the VA's adoption of a team-based Patient Centered Medical Home model for primary care. She is the Director of the HSR&D Interprofessional Learning & Practice Partnered Evaluation Center, funded by VA's Office of Academic Affiliations and QUERI. She is one of four Principal Investigators on a national evaluation of the VA Innovators Network and a co-investigator on several studies examining topics including how to improve services for women Veterans experiencing Intimate Partner Violence and Veterans experiencing homelessness. Her work often utilizes realist, action-oriented, and/or participatory approaches to engage health system workers and patients in co-creating knowledge for health system redesign. She has conducted research and evaluation work both within VA and with community groups in Portland, and she is an active participant in the OHSU-PSU Social Determinants of Health Initiative.

Innovators Network – Population factors, Organizational capacity, Workflow and Resources (IN-POWR) (Principal Investigator)

This comprehensive Partnered Evaluation Initiative will identify impacts of VA Innovators Network training and other activities on employee engagement and retention as well as return on investment and impacts on health care utilization/quality of care metrics associated with innovations developed by Network members.
Principal Investigators: Anais Tuepker, Cutrona, Vashi, and Jackson

Action Oriented Evaluation of Interprofessional Learning Efforts in the COEPCE and IAPACT Environments (Principal Investigator)

This project established a Partnered Evaluation Center with the goal of evaluating the development, dissemination and adoption of tools to promote interprofessional training and learning throughout VA primary care, looking at impacts on the organization of care delivery, patient outcomes, and employee/trainee experience.
Grant ID: PEC 15-247

Opening the Black Box of Cultural Competence (Co-Investigator)

The goal of this project is to understand differences in the way providers with high vs. low levels of “cultural competence” interact with patients, through direct observation of patient-provider communication and interviews with patients.
Principal Investigator: Somnath Saha
Grant ID: IIR 14-007-3

Using Behavioral Economics to Enhance Appointment Reminders and Reduce Missed Visits (Co-Investigator)

The primary objective of this study is to design and evaluate the effect of appointment reminders enhanced by principles of behavioral economics versus standard appointment reminders on no-show rates and other access-related metrics in primary care and mental health clinics.
Principal Investigator: Alan Teo
Grant ID: VA HSR&D IIR


  • Edwards ST, Kim H, Shull S, Hooker ER, Niederhausen M, Tuepker A. Quality of Outpatient Care With Internal Medicine Residents vs Attending Physicians in Veterans Affairs Primary Care Clinics. JAMA Internal Medicine. 2019 Apr;179(5):711-713. doi:10.1001/jamainternmed.2018.8624
  • Pisciotta MK, Denneson LM, Williams HB, Woods S, Tuepker A, Dobscha SK. Impacts of a web-based educational program for veterans who read their mental health notes online, Journal of Mental Health. 2019;26(1):3-8.